Objective: To investigate the level of self-efficacy and disability in patients with rheumatoid arthritis (RA) and to examine the relationship of patient self-efficacy and disability with age and disease duration. Methods: A cross-sectional survey was conducted at the department of rheumatology in JPMC, Karachi from June to November 2017. Patients who had RA as main disease, age above fifteen years, disease duration of three months or above and cognitively able to answer the questionnaires were consecutively included. Self-efficacy was measured by Arthritis Self-Efficacy Scale (ASES) and disability assessed by Health Assessment Questionnaire. The relationship between ASES and disability, age and disease duration were examined using Spearman's rho test. Statistical analysis was undertaken using SPSS for Windows, version 22. Results: Of 100 RA patients, 32% had average self-efficacy. Whereas moderate to severe disability existed in 59% of the patients. A spearman's correlation showed that arthritis self-efficacy was strongly correlated with disability (r= -0.751, p= <.0001), moderately with disease duration (r= -0.359, p= <0.0001) and weakly with age (r= -0.284, p= 0.004) whereas disability had direct moderate correlation with age and disease duration (r= 0.396, p= <0.0001 and r= 0.423, p= <0.0001, respectively). Conclusion:This cross-sectional survey concluded that average self-efficacy and moderate to severe disability exist in RA patients. Enhancing the patient's self-efficacy should be an essential part of a total treatment program of RA so that disability, treatment cost and visits to health care system could be reduced.

Objective: To evaluate physiotherapists' perceptions regarding importance of patient's adherence to physiotherapist prescribed selfmanagement strategies in improving patients outcomes as well as to identify perceived barriers by physiotherapists in employing methods to aid adherence. Materials and Methods: A cross-sectional survey was conducted on 120 physiotherapists using non-probability purposive sampling technique. Only those physiotherapists who worked clinically more than 15 hours per week and had an experience of treating adult patients with average patient load of 80% or greater were included in the study. The questionnaires were self-administered by researcher. The data was analyzed using descriptive statistics (frequency and percentage) by SPSS version 22. Results: Most of the physiotherapists' .i.e. 90.8% perceived that individualizing the self-management techniques to the patients as the most important method to improve patient adherence to self-management techniques in positively influencing outcomes. However major barriers that prevent physiotherapists from employing methods to improve patients' adherence were lack of time 38.3% and lack of resources 44.2%. Conclusion:This survey concluded that physiotherapists perceive that patients adherence to self-care techniques can significantly affect treatment outcomes. However lack of time and limited asses to resources were the barriers that mostly prevent physiotherapist s from employing methods to aid adherence. Therefore physiotherapists should be focused to apply evidence-based methods to maintain patients' adherence.

BACKGROUND AND AIMS Parkinson disease is the 2nd most common neurological disorder worldwide that is mainly associated with motor system. The role of non-pharmacological treatment in the management of fall, posture and improving quality of life is yet unclear therefore this review was conducted to evaluate the effects of physiotherapy interventions on fall, posture and quality of life in PD patients. DATABASES AND ELIGIBILITY CRITERIA A literature search was conducted through Google Scholar, PEDro, Cochrane Library, Med-line, CINAHL, Web of Science and PubMed included 18 randomized controlled trials evaluating physiotherapy interventions effects on fall, posture or QOL in PD patients that published in the year 2010 to onwards 2019 were included. RESULTS Methodological quality and risk of bias was assessed using the Cochrane tool for assessing risk of bias. The findings revealed that PT treatments like resistance training, balance exercises, exergaming and low-intensity trunk exercises are effectual in enhancing QOL and postural imbalance. However resistance strength training, fall education and gait training more effectively reduces fall. CONCLUSION Physiotherapy interventions play an essential role in the treatment of fall, postural imbalance and QOL. These interventions should be integrated in the treatment plan so that PD patients can achieve greater independence in their lives.

Abstract Objective: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death and it causes pulmonary and extrapulmonary symptoms, also impacts the quality of life. Rigorous evidence on manual and mechanical chest physiotherapy is still scarce. Therefore, this review aims to evaluate the effects of different exercise therapies on obstruction, dyspnea and quality of life in obstructive patients. Materials and Methods: Databases such as Medline, BioMed Central, CINHAL and Cochrane were reviewed. We performed a systematic review of randomized controlled trials published from 2011 to 2020, to evaluate the effects of exercise therapies on obstruction, dyspnea and quality of life in obstructive patients. Methodological quality and risk of bias were assessed using the Cochrane tool. Results: Most of the trials supported the effectiveness of mechanical chest physiotherapy in improving obstruction, dyspnea and quality of life. Conclusion: High-to-moderate evidence shows that mechanical chest physiotherapy is useful in the improvement of obstruction, dyspnea and quality of life in obstructive patients.   Keywords: Borg dyspnea scale, COPD, High-frequency chest wall oscillation, mMRC dyspnea scale, St. George Respiratory Questionnaire, Spirometry

Background: Cancer is ranked as the 2nd common deadliest disorder worldwide, and the growing incidence demands updating and optimizing the treatment strategies for cancer survivors. However, evidence regarding this area is scarce; therefore, this systematic review aimed to evaluate the effects of Physiotherapy (PT) in managing cancer-related pain and fatigue. Methodology: Electronic search conducted utilizing Google Scholar, Embase.com, Cochrane CENTRAL via Wiley, Web of Science Core Collection, MEDLINE via Ovid, PEDro, and PubMed. Randomized controlled trials published from 2014 to April 2021 analyzing the effects of PT approaches for cancer-related pain and/or fatigue management in adult cancer patients were included in the review. Sixteen eligible trials were evaluated, of which eight trials addressed Cancer-Related Pain (CRP) while others addressed Cancer-Related Fatigue (CRF). The risks of bias and trials credibility were analyzed via the Cochrane tool to assess bias risk. Results: Strong evidence favors the effectiveness of various PT approaches mainly, aerobic and resistance exercises for CRF and CRP management. However, endurance exercises, high-intensity interval training, and myofascial release were effective in CRF management. In contrast, Xbox Kinect-based games, stretching, lymphatic drainage, and passive mobilization effectively reduced CRF. Conclusion: Large body of evidence supports the effectiveness of PT exercises mainly, aerobic and resistance exercises, in cancer-associated pain and fatigue management. Hence exercises prescriptions should be implemented in the treatment plan of cancer patients.